E

E&O. See Errors and Omissions Insurance.

E&S. See Excess and Surplus Lines Insurance.

EAP. See Employee Assistance Program.

Early and Periodic Screening, Diagnosis and Treatment (EPSDT). Programs that cover screening and diagnostic services to determine physical or mental defects in recipients under age 21, as well as health care and other measures to correct or ameliorate any defects and chronic conditions discovered.

Early Warning Tests. See Insurance Regulatory Information System.

Earned Premiums. The prorated portion of an insurance premium that no longer is considered prepaid due to the elapsed time the policy has been in force. For example, after six months, $50 of a prepaid $100 annual premium is considered earned premium.

Earthquake Project. An initiative begun in 1988 by U.S. property-casualty insurers to call attention to losses that would arise from a major earthquake within the United States. The initiative calls for government incentives to enable insurers to build up appropriate reserves for such an event.

ECF. See Extended Care Facility.

Effective Date. The date on which coverage begins under an insurance policy.

Eligibility Date. The date on which a participant's eligibility period begins.

Eligibility Period. The amount of time during which qualified participants in a group policy may choose to participate as members of the insured group without furnishing evidence of insurability.

Elimination Period. The initial period of time during which benefits under a health insurance policy are not payable.

Employee Assistance Program (EAP). A mental health managed care program, in which a gatekeeper evaluates a patient before referral for the appropriate course of treatment. The evaluation could include a number of office visits, as well as testing. EAP programs typically were started as an in-house, less expensive way for employees to obtain advice and treatment in such areas as substance abuse and other psychological needs, and have evolved as a way to extend managed care to mental health coverage.

Employee Retirement Income Security Act (ERISA). Federal legislation enacted in 1974 applicable to most private pension and welfare plans. The legislation seeks to protect covered employees by establishing certain minimum standards for such plans.

Employee Stock Ownership Plan (ESOP). A defined contribution pension plan that invests primarily in the securities of the employer.

End-Stage Renal Disease. Most people who need a kidney transplant or renal dialysis because of chronic kidney disease are automatically covered under Medicare Part A.

Endorsement. An amendment to, or other alteration of, the original insurance policy; also known as a rider.

Endowment Life Insurance. A form of whole life insurance for which premiums are paid until a fixed date, at which time the policy matures and benefits are available to the policyholder. See Whole Life Insurance.

Enrollee. Any person eligible as either a subscriber or a dependent for service in accordance with a contract.

EPO. See Exclusive Provider Organization.

ERISA. See Employee Retirement Income Security Act.

Errors and Omissions (E&O) Insurance. A form of insurance that covers an insured's liability for any actual or alleged breach or neglect of duty committed in the conduct of the insured's business activities.

ESOP. See Employee Stock Ownership Plan.

Estoppel. A legal principle by which a person is precluded from denying the veracity of a statement previously made.

Examination. The process whereby regulators inspect the books and records of an insurer to verify their financial condition and compliance with applicable laws and regulations.

Excess and Surplus (E&S) Lines Insurance. A form of insurance that covers risks for which insurance is unavailable from admitted insurers.

Excess and Surplus (E&S) Lines Insurer. An insurer that, although not licensed to transact business within a given state, writes excess and surplus insurance as a nonadmitted insurer with greater freedom from regulatory restrictions applicable to admitted insurers.

Excess-of-Loss Reinsurance. A form of reinsurance in which the insurer cedes and the reinsurer assumes all or a portion of losses in excess of a specified retention level up to a predetermined limit; also known as nonproportional reinsurance.

Excess Surplus. The amount of surplus over and above that required to meet defined required surplus standards. Also known as "free surplus."

Exclusion. A provision in an insurance policy that eliminates coverage for certain risks, persons, classes of property or locations. In an all-risks policy, excluded items are listed explicitly in the policy. In a named-perils policy, exclusions are understood to be all those risks not listed as being covered.

Exclusive Agent. An insurance agent who has agreed to provide exclusive representation to one insurer; also known as a captive agent.

Exclusive Provider Organization (EPO). A managed care organization that is organized similarly to PPOs in that physicians do not receive capitated payments, but which only allows patients to choose medical care from network providers. If a patient elects to seek care outside of the network, then he or she will not be reimbursed for the cost of the treatment. See Preferred Provider Organizations.

Exclusivity Clause. A part of a contract that prohibits physicians from contracting with more than one managed care organization (HMO, PPO, IPA, etc.).

Exemplary Damages. See Punitive Damages.

Expense Loading. See Loading.

Expense Ratio or Underwriting Expense Ratio. The ratio of an insurer's underwriting expenses to net premiums written, if determined in accordance with statutory accounting practices; or the ratio of underwriting expenses (adjusted by deferred acquisition costs) and operating expenses (excluding interest expense) to earned premiums, if determined in accordance with generally accepted accounting principles.

Experience. The loss history of an insured or a particular class of business.

Experience Rating. A method of setting premium levels for an insured based upon the insured's loss history. Also known as retrospective rating.

Expiration Date. The date on which insurance coverage ends.

Exposure. A unit of measurement of risk being assumed by the insurer. For example, wages serve as the basis for calculating workers' compensation exposure.

Extended Care Facility (ECF). A nursing or convalescent home offering skilled nursing care and rehabilitation services.

Extended Coverage Insurance. Supplemental protection provided against perils in addition to those perils covered in a basic fire insurance policy.

Extended Warranty Insurance. A form of insurance that provides warranty protection against faulty construction for a term beyond the warranty period provided by the manufacturer.

Extra-Contractual Obligations or Liability. See Punitive Damages.

Exxon Valdez. A notable casualty loss resulting from the grounding of the oil supertanker, Exxon Valdez, off the coast of Alaska in 1989.